title: Antibiotic prophylaxis at triage for simple traumatic wounds: a pilot study.
abstract: Antibiotic administration at the time of wound manipulation has not been shown to decrease infection rates for simple traumatic wounds. Antibiotic administration at the time of initial emergency department (ED) presentation, however, has not been explored. Patients presenting to the ED with simple traumatic wounds received 1 g of oral flucloxacillin, or identical placebo, at triage. Wound closure was completed at the discretion of a physician blinded to study contents. Wound infection rates were determined at 1 month. Time from drug administration to wound manipulation was 64.3 min [95% confidence interval (CI) 36.6-91.9] placebo versus 75.0 min (95% CI: 51.7-98.3) flucloxacillin, P=0.657. Six of 36 patients (17%) reported wound infection in the placebo group, and four of 34 (12%) in the flucloxacillin group, P=0.736. Administration of oral flucloxacillin at triage failed to reduce the rate of wound infection for simple traumatic wounds closed in the ED.
authors.affiliation: Department of Emergency Medicine, Waikato Hospital, Hamilton, New Zealand.
authors.forename: David Lord
authors.initials: DL
authors.lastname: Cowell
authors.forename: Martyn
authors.initials: M
authors.lastname: Harvey
authors.forename: Grant
authors.initials: G
authors.lastname: Cave
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D001424:Bacterial Infections / Q000209:etiology / Q000517:prevention & control*; D016001:Confidence Intervals; D005260:Female; D005436:Floxacillin / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D010865:Pilot Projects; D012307:Risk Factors; D013997:Time Factors; D014218:Triage / Q000379:methods*; D014947:Wounds and Injuries / Q000150:complications* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D005436:Floxacillin